Disc Excision using Transanal Circular Stapler for Deep Endometriosis of the Rectum in 10 Steps

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Disc Excision using Transanal Circular Stapler for Deep Endometriosis of the Rectum in 10 Steps. / Roman, Horace.

In: Journal of minimally invasive gynecology, Vol. 28, No. 1, 01.2021, p. 14-15.

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Roman, Horace. / Disc Excision using Transanal Circular Stapler for Deep Endometriosis of the Rectum in 10 Steps. In: Journal of minimally invasive gynecology. 2021 ; Vol. 28, No. 1. pp. 14-15.

Bibtex

@article{ec8af315761d469d87b77d4b1189f7d0,
title = "Disc Excision using Transanal Circular Stapler for Deep Endometriosis of the Rectum in 10 Steps",
abstract = "Objective: Deep endometriosis infiltrating the rectum may be managed by full-thickness disc excision, with the goal of preserving rectal function and avoiding low anterior rectal resection syndrome (Supplemental Appendix 1). Transanal staplers may be successfully used to remove rectal wall discs and concomitantly to perform rectal suture. The goal of this video article is to identify 10 steps that may render the procedure standardized and reproducible. Design: Step-by-step video demonstration of the procedure. Setting: A French tertiary referral center. Interventions: The video presents disc excision of deep endometriosis infiltrating the rectum using a transanal circular stapler, following 10 steps: (1) nodule dissection and rectum releasing; (2) rectal shaving; (3) removal of fat tissue on the lateral rectal wall; (4) placement of a suture on the shaved area; (5) introduction of the closed transanal circular stapler; (6) stapler opening at the nodule's level; (7) knot performing; (8) stapler closing and firing; (9) stitches reinforcing the stapled line; and (10) performing a bubbles test. From 2009 to 2020, the author has performed this procedure in 205 patients: the mean disc diameter was 40 ± 8 mm; microscopic foci were found on the disc edges in 25.7%; and the rectal recurrence rate was 1.5%, whereas the leakage rate was 4.4%. The local institutional review board stated that approval was not required because the video describes a technique and does not report a clinical case. Conclusion: Disc excision using a transanal circular stapler following 10 steps is a standardized and reproducible procedure. The learning curve may be short because colorectal surgeons routinely employ the stapler to perform laparoscopic colorectal anastomosis.",
keywords = "Bowel, Colorectol endometriosis, Deep endometriosis, Full thickness excision, Intestinal endometriosis",
author = "Horace Roman",
note = "Video Article",
year = "2021",
month = jan,
doi = "10.1016/j.jmig.2020.04.017",
language = "English",
volume = "28",
pages = "14--15",
journal = "Journal of Minimally Invasive Gynecology",
issn = "1553-4650",
publisher = "Elsevier Inc.",
number = "1",

}

RIS

TY - JOUR

T1 - Disc Excision using Transanal Circular Stapler for Deep Endometriosis of the Rectum in 10 Steps

AU - Roman, Horace

N1 - Video Article

PY - 2021/1

Y1 - 2021/1

N2 - Objective: Deep endometriosis infiltrating the rectum may be managed by full-thickness disc excision, with the goal of preserving rectal function and avoiding low anterior rectal resection syndrome (Supplemental Appendix 1). Transanal staplers may be successfully used to remove rectal wall discs and concomitantly to perform rectal suture. The goal of this video article is to identify 10 steps that may render the procedure standardized and reproducible. Design: Step-by-step video demonstration of the procedure. Setting: A French tertiary referral center. Interventions: The video presents disc excision of deep endometriosis infiltrating the rectum using a transanal circular stapler, following 10 steps: (1) nodule dissection and rectum releasing; (2) rectal shaving; (3) removal of fat tissue on the lateral rectal wall; (4) placement of a suture on the shaved area; (5) introduction of the closed transanal circular stapler; (6) stapler opening at the nodule's level; (7) knot performing; (8) stapler closing and firing; (9) stitches reinforcing the stapled line; and (10) performing a bubbles test. From 2009 to 2020, the author has performed this procedure in 205 patients: the mean disc diameter was 40 ± 8 mm; microscopic foci were found on the disc edges in 25.7%; and the rectal recurrence rate was 1.5%, whereas the leakage rate was 4.4%. The local institutional review board stated that approval was not required because the video describes a technique and does not report a clinical case. Conclusion: Disc excision using a transanal circular stapler following 10 steps is a standardized and reproducible procedure. The learning curve may be short because colorectal surgeons routinely employ the stapler to perform laparoscopic colorectal anastomosis.

AB - Objective: Deep endometriosis infiltrating the rectum may be managed by full-thickness disc excision, with the goal of preserving rectal function and avoiding low anterior rectal resection syndrome (Supplemental Appendix 1). Transanal staplers may be successfully used to remove rectal wall discs and concomitantly to perform rectal suture. The goal of this video article is to identify 10 steps that may render the procedure standardized and reproducible. Design: Step-by-step video demonstration of the procedure. Setting: A French tertiary referral center. Interventions: The video presents disc excision of deep endometriosis infiltrating the rectum using a transanal circular stapler, following 10 steps: (1) nodule dissection and rectum releasing; (2) rectal shaving; (3) removal of fat tissue on the lateral rectal wall; (4) placement of a suture on the shaved area; (5) introduction of the closed transanal circular stapler; (6) stapler opening at the nodule's level; (7) knot performing; (8) stapler closing and firing; (9) stitches reinforcing the stapled line; and (10) performing a bubbles test. From 2009 to 2020, the author has performed this procedure in 205 patients: the mean disc diameter was 40 ± 8 mm; microscopic foci were found on the disc edges in 25.7%; and the rectal recurrence rate was 1.5%, whereas the leakage rate was 4.4%. The local institutional review board stated that approval was not required because the video describes a technique and does not report a clinical case. Conclusion: Disc excision using a transanal circular stapler following 10 steps is a standardized and reproducible procedure. The learning curve may be short because colorectal surgeons routinely employ the stapler to perform laparoscopic colorectal anastomosis.

KW - Bowel

KW - Colorectol endometriosis

KW - Deep endometriosis

KW - Full thickness excision

KW - Intestinal endometriosis

UR - http://www.scopus.com/inward/record.url?scp=85084458109&partnerID=8YFLogxK

U2 - 10.1016/j.jmig.2020.04.017

DO - 10.1016/j.jmig.2020.04.017

M3 - Journal article

C2 - 32335183

AN - SCOPUS:85084458109

VL - 28

SP - 14

EP - 15

JO - Journal of Minimally Invasive Gynecology

JF - Journal of Minimally Invasive Gynecology

SN - 1553-4650

IS - 1

ER -